Provider Demographics
NPI:1699960161
Name:JAN L. COON LCSW COUNSELING & THERAPY SERVICES LLC
Entity type:Organization
Organization Name:JAN L. COON LCSW COUNSELING & THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:L
Authorized Official - Last Name:COON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:303-475-8398
Mailing Address - Street 1:8795 RALSTON RD STE 234
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-2353
Mailing Address - Country:US
Mailing Address - Phone:303-475-8398
Mailing Address - Fax:303-474-5223
Practice Address - Street 1:8795 RALSTON RD STE 234
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-2353
Practice Address - Country:US
Practice Address - Phone:303-475-8398
Practice Address - Fax:303-474-5223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9899251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC552098OtherMEDICARE GROUP NUMBER
COC552098OtherMEDICARE GROUP NUMBER